Karami Hossein, Arbab Amir Haji Mohammad Mehdi, Rezaei Alireza, Mohammadhoseini Mojtaba, Rezaei Iraj
Urology and Nephrology Research Center, Tehran, Iran.
J Endourol. 2009 Jan;23(1):33-5. doi: 10.1089/end.2008.0433.
Our aim was to evaluate the safety and efficacy of percutaneous nephrolithotomy (PCNL) with ultrasonography (US)-guided renal access in the lateral decubitus flank position.
From July 2006 to March 2008, 40 patients with renal stones > 2 cm underwent PCNL with US-guided renal access in the lateral decubitus flank position by a single surgeon. We report our technique and the outcomes in detail.
Successful access was achieved in 40 patients (100%). Complete stone clearance rate was 85% (34 patients). After surgery, six (15%) patients had stones (6-11 mm) detected by plain abdominal radiography or sonography and were referred for shockwave lithotripsy. The mean stone size was 29 mm (range 22-43 mm). The mean operative time was 45 minutes (range 32-75 min), and the mean hospital stay was 2.8 days (range 2-4 d). Postoperative US did not reveal considerable fluid collection. There were no visceral injuries. Also, there was no significant bleeding that led to transfusion intraoperatively and postoperatively.
PCNL with US-guided renal access in the lateral decubitus flank position is safe and convenient, and prevents harmful effects of radiation for the surgeon, the surgical team, and the patient.
我们的目的是评估在侧卧位经皮肾镜取石术（PCNL）中超声（US）引导下肾脏穿刺入路的安全性和有效性。
2006年7月至2008年3月，40例肾结石直径大于2cm的患者由同一位外科医生在侧卧位经超声引导下进行肾脏穿刺入路的PCNL手术。我们详细报告了我们的技术及结果。
40例患者（100%）穿刺成功。结石完全清除率为85%（34例患者）。术后，6例（15%）患者经腹部平片或超声检查发现有结石（6 - 11mm），并接受了冲击波碎石治疗。结石平均大小为29mm（范围22 - 43mm）。平均手术时间为45分钟（范围32 - 75分钟），平均住院时间为2.8天（范围2 - 4天）。术后超声检查未发现明显的积液。无内脏损伤。此外，术中及术后均无导致输血的明显出血情况。
在侧卧位经超声引导下肾脏穿刺入路的PCNL手术安全便捷，可避免辐射对外科医生、手术团队及患者产生有害影响。
